Sunday, March 25, 2007

Avian Influenza and the Risk to Human Health

The center running of the concern rests on the epizootic one without precedent of the disease of H5N1 HPAI, its current and obvious widespread diffusion of direct poultry transmission to the human ones. The detection of A/H5N1 in the pigs in Indonesia and China announces the possibility of reassortment of A/H5N1 and the human viruses in pigs.13 however in spite of the million human exposures, from the human and avian viruses containing viruses reassortant of influenza of origin did not emerge yet, suggesting a difficult process of adaptation for infections A/H5N1 at the man and a low probability of reassortment due to a restricted number the human ones infected up to now. The phase of pandemia of WHO remains with phase 3 (human of alarm of pandemia infected by a new constraint with only the very occasional person with the isolated person). The risk however increases with the total diffusion continues the epizootic one.

Human pandemias of influenza of the 20th century were caused by H2, flu viruses H1 and H3, the genes of hémagglutinine coming from the avian viruses of influenza. These three sub-types are low pathogenic in avian species and thus there was no warning anticipated of the demonstrations in the poultry before the beginning of these pandemias. Next human pandemia still could result from a low pathogenic constraint, or reappearance of the already human adapted A/H2N2, or indeed of reassortment or adaptive change of A/H5N1. Stohr described pandemias as typically striking populations of the world as the flash floods, starting abruptly and explosivement, leaving considerable damage in their wake. The appearance of the human cases of A/H5N1 acted as a warning and we must prepare now while better us can to mitigate the effects of next pandemia, any sub-type it can finally prove to be. All the clinicians must consider emergency plans for such an event.

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